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Authors Posts by Melissa Dehoff

Melissa Dehoff

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Melissa Dehoff is responsible for all medical rehabilitation and brain injury service issues. Ms. Dehoff attends multiple state-level meetings to advocate on behalf of members on brain injury and rehabilitation issues and is a member of the Department of Health Traumatic Brain Injury Advisory Board.

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Image by StockSnap from Pixabay

The Long-Term Services and Supports (LTSS) Subcommittee meeting was held yesterday, November 6, 2024. During the meeting, a number of presentations were given. In addition to the presentations, the agenda and a document that provided follow-up items from the October 2, 2024, LTSS Subcommittee meeting were provided.

Members should take time to review the PowerPoint presentations from the meeting below:

The 2025 meeting dates for the LTSS Subcommittee were also shared:

  • January 8, 2025
  • February 5, 2025 (virtual only)
  • March 5, 2025 (virtual only)
  • April 2, 2025
  • May 7, 2025
  • June 4, 2025
  • July 2, 2025
  • August 6, 2025
  • September 3, 2025
  • October 1, 2025
  • November 12, 2025
  • December 3, 2025

The meetings will continue to be held from 10:00 am – 1:00 pm.

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RCPA has been notified about an interesting brain injury project in development that will benefit survivors, care partners, and professionals.

This project is being led by staff from the University of Washington, with a number of individuals from Pennsylvania working with them. The project aims to develop the National Brain Injury Network — a network connected by a website offering resources, research, and a platform for connection among those with lived experience, care partners, and health care providers. Please use this link for more information about this project.

A very quick survey was developed to gather feedback that will play a crucial role in shaping the site to ensure it meets the needs and priorities of the brain injury community. Participation is voluntary and anonymous. RCPA’s brain injury providers are strongly encouraged to complete the survey and also to pass it on to others within your networks (professionals, survivors, and caregivers). If you have questions or comments, please contact the Brain Injury Network core team.

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Photo by Tingey Injury Law Firm on Unsplash

Novitas Solutions has announced that there are changes to the Amount in Controversy (AIC) for appeals filed on or after January 1, 2025. The AIC requires the claims value in dispute to meet the threshold for obtaining an Administrative Law Judge (ALJ) hearing and a judicial review in federal district court. The AIC is recalculated and published on an annual basis and is identified in a provider’s appeal notice of decision.

The AIC for appeals filed on or after January 1, 2025:

  • ALJ hearing will increase to $190.
  • Federal district court will increase to $1900.

The amount in controversy is calculated in the following manner:

  • Amount Charged minus Medicare Payments Already Made or Awarded = Subtotal Balance
  • Subtotal Balance minus Any Applicable Deductible/Coinsurance = AIC

Novitas Solutions is the Medicare Administrative Contractor (MAC) for Jurisdiction JL, which includes DC, DE, MD, NJ, and PA.

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Two announcements regarding fall/winter 2024 training programs were recently released for personal care home (PCH) and assisted living residence (ALR) administrators. Both training programs are free of charge and may be counted toward the annual administrator training requirement.

The training programs include:

If you would like to participate in these online training programs, please visit the above links as well as their respective announcements to register for the courses. You need only to register for one session for each course. Please read the training announcement in full before registering to ensure you can meet the participation requirements.

Please only register for a session if you are sure you will be able to attend. Participation is limited. If you register and later discover you are unable to participate, please cancel your registration to create space for other participants.

If you have any questions or if you require assistance with registration, please email the PCH Admin inbox.

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The agenda for the November 6, 2024, Long-Term Services and Supports (LTSS) Subcommittee meeting has been released by the Department of Human Services (DHS) Office of Long-Term Living (OLTL). The meeting will be held from 10:00 am – 1:00 pm in the Honors Suite, 1st floor, 333 Market Street, Harrisburg, PA 17126. Attendees have the option to attend in person or via webcast. The links and call information are below:

Conference line: Bridge Number: 1-415-655-0060 PIN: 789-496-398#
Webinar Link
Remote Streaming Link

Comments and questions may be sent via email.

The mission of the LTSS Subcommittee is to be a resource to the Medical Assistance Advisory Committee (MAAC), enabling the committee to advise the Department of Human Services on issues regarding access to service and quality of service.

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The Pennsylvania Department of Aging has released information about the 2024 Alzheimer’s Disease and Related Disorders (ADRD) virtual forum. The forum, “Brain Health and Beyond: Taking Care of Your Brain as You Age,” is scheduled for November 7, 2024, from 9:00 am – 12:30 pm.

The agenda for the forum is located here. To participate in the virtual forum, registration is required.

Questions regarding the virtual forum should be directed to Heidi Champa, Aging Services Specialist, via email.

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The Department of Health’s Brain Injury Advisory Board, established under section 1252 of the Federal Traumatic Brain Injury Act of 1996 (42 U.S.C. § 300d-52), will hold their next public meeting on Friday, November 1, 2024, from 10:00 am to 3:00 pm. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network, 6340 Flank Drive, Harrisburg, PA 17112 in the Cambria conference room.

Meeting materials will be sent out before the meeting and will also be available on the Board’s website and at the meeting location. Questions should be directed to Nicole Johnson.

The Department of Health’s Head Injury Program (HIP) strives to ensure that eligible individuals who have a traumatic brain injury receive high quality rehabilitative services aimed at reducing functional limitations and improving quality of life. The Board assists the department in understanding and meeting the needs of persons living with acquired brain injuries, both traumatic and nontraumatic, and their families. This quarterly meeting provides updates on a variety of topics, including the number of people served by HIP. In addition, meeting participants will discuss budgetary and programmatic issues, community programs relating to traumatic and nontraumatic brain injuries, and available advocacy opportunities.

For additional information or for persons with a disability who wish to attend the meeting and require an auxiliary aid, service, or other accommodation to do so, contact Nicole Johnson, Division of Community Systems Development and Outreach, 717-772-2763. For individuals with speech and/or hearing impairments, contact V/TT 717-783-6514 or the Pennsylvania Hamilton Relay Service at 800-654-5984. This meeting is subject to cancellation without notice.

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The Office of Long-Term Living (OLTL) has announced that they are reopening the calendar year (CY) 2023 rate study survey in order to gather responses from providers that were not able to submit previously. The rate study survey is for the following Home and Community-Based Services (HCBS):

  • Adult Day;
  • Structured Day Habilitation;
  • Employment and Training;
  • Personal Assistance (Agency);
  • Personal Assistance (Participant Directed); and
  • Residential Habilitation.

Access the survey here. Please complete the survey for CY 2023, which spans from January 1, 2023, through December 31, 2023, unless otherwise specified. Please only complete the survey if you did not previously participate. The reopening of the survey will ensure every provider has ample time to offer input to broaden and improve the resulting analysis. The survey will remain open until Friday, November 15, 2024.

It is highly recommended that you review the survey questions before starting the survey. This survey tool does not allow individuals to save and go back to answer questions. Have all your agency information such as wages, employee information, and financial statements readily available. This will help you to submit accurate information when answering the questions.

This survey is one piece of the targeted rate review and is intended to collect current provider rate and wage data and general feedback on the challenges of providing these services. The information collected in this survey will be used to assist in developing a point of reference for the rate range to evaluate current payment rates. In addition to results from this survey, the review will include payment rate information from Managed Care Organizations (MCO) in OLTL claims data, recent legislative policies, department expectations, and other data obtained from publicly available sources.

HCBS providers that delivered multiple service categories during CY 2023 should fill out this survey separately for each service category you delivered.

HCBS providers that did not deliver any of the service categories listed above should disregard this survey. OLTL is partnering with Mercer to perform a rate study exclusive to the service categories listed above at this time.

The information collected for this survey will be used for both this rate study and to meet the requirements of House Bill 1300 from the 2023–2024 Pennsylvania General Assembly regular session. The information you provide will remain confidential and private and will only be shared publicly through high-level summary reports that do not include provider-level detail. Please comply with the Health Insurance Portability and Accountability Act (HIPAA) and do not share any protected health information (PHI) within your survey responses.

If you have any questions or need assistance, please reach out via email.

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Photo by Glenn Carstens-Peters on Unsplash

The Office of Long-Term Living (OLTL) recently released a reminder to ensure that all agencies have correct contact information on file with them in accordance with § 52.14 (j)(1) (related to ongoing responsibilities of providers), which states that a provider shall notify the Department of Human Services’ (DHS) OLTL at least 30-days prior to changes in the provider’s address, telephone number, fax number, email address, provider name change, or provider’s designated contact person.

Additionally, it is imperative that the participant’s designated service coordinator’s correct information is included in the Home and Community Services Information System (HCSIS). Please ensure that the correct service coordinator’s (SC) name and contact information are accurate on each Individual Service Plan (ISP) assigned to them. OLTL uses this information to contact providers for many reasons specific to your agency, and it is important that members of their team have accurate information, as some of these contacts require immediate follow-up.

Please verify that your agency and staff member contact information is accurate and correct in HCSIS and PROMISe™ no later than 30 Days from Notice. If changes are needed to the SC and/or SC Supervisor contact on the Caseload Facesheet page, work with your agency’s designated Business Partner Administrator (BPA) and SC Supervisors to make the applicable changes to your agency’s caseload. If you are unsure of how to make those changes, all training materials are located in the HCSIS Learning Management System (LMS). If you do not have access to LMS, please contact your agency’s BPA.

To update your information with OLTL, complete the Change of Information form and send the completed form and any required supporting documents electronically.

If you have any questions regarding this communication, please contact the Division of Provider Operations, Enrollment and Certification Section inbox or call 800-932-0939, Option 1, Monday through Friday, 9:00 am – 12:00 pm and 1:00 pm – 4:00 pm.

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The agenda for the October 2, 2024 Long-Term Services and Supports (LTSS) Subcommittee meeting has been released. The meeting is scheduled for 10:00 am – 1:00 pm and will be held via webinar.

To participate in the meeting, please register here. After registering, you will receive a confirmation email containing information about joining the webinar. If you plan to participate via phone, the dial-in number is: 562-247-8422; Access Code: 681 281 984#.

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